Major marketplace forces will continue to reshape the healthcare industry landscape in 2015. Rather than creating additional challenges that must be overcome, I see them as creating opportunities that must be embraced by healthcare providers.
That’s particularly true for health system pharmacies, which can take advantage of those opportunities to improve the health of their patients and the business health of their own organizations. I see five trends specifically affecting health system pharmacies in 2015 that will generate exactly those types of opportunities. Here are the five trends to watch for in the year ahead.
1. Increased opportunities in specialty
Experts project that 50 percent of all spending on prescription medication by 2018 will be for specialty drugs, which are complex pharmaceuticals that require special handling, administration and monitoring by healthcare providers. This trend creates two opportunities for health system pharmacies. The first is improved patient safety. The second is increased revenue. The solution is becoming a specialty pharmacy or gaining access to specialty drugs, both of which can result in better health for patients and better business health for providers.
2. Pharmacy becomes revenue generator
The days of operating a pharmacy as a cost center that receives little or no attention from upper management are over. In 2015, health system pharmacies will be expected to become revenue-generators. We’ll see more opening up on-site and off-site ambulatory pharmacies. At the same time, health system pharmacies will look at supply chain and inventory management strategies to increase efficiencies and reduce expenses.
3. New payment models elevate role of pharmacists
Value-based payment models will continue to proliferate in 2015 and so will the responsibility of health system pharmacies. Since Medicare reimbursements increase or decrease based on how well a hospital performs on a mix of clinical process, patient experience and clinical outcome measures, health system pharmacies will need to provide patients the right medication in the right dosage at the right time. Over the next year, expect to see a greater focus on medication adherence, “meds-to-beds” programs that give patients their prescribed medications before they’re discharged from the hospital, and medication therapy management programs.
4. Growing demand for 340B audit preparedness
Established in 1992 as a way for providers to buy outpatient prescription drugs at a discount to make them more affordable for uninsured and underinsured patients, the 340B program has come under fire for alleged lack of oversight of the nearly $7 billion in drugs sold annually under the program. Due to increased regulations and growing oversight, the number of 340B audits by HHS’ Health Resources and Services Administration will increase. This means health system pharmacies that operate 340B programs need to make themselves “audit proof” by using internal compliance programs and technologies that:
- Accurately track 340B eligible patients
- Analyze every drug dose processed and correctly calculate drug charges
- Maintain a detailed record for the audit trail
5. Big data key to improving patient care
Big data will continue to play an increasingly important role in health system pharmacies. Using advanced data analytics software will allow health system pharmacies to track the medication history of patients that arrive in their facilities regardless of where they received their previous prescriptions. Hospitals will also use big data to analyze the prescribing practices of individual physicians, which will help determine who is over or under prescribing. As a result, this will have an impact on the quality and safety of patient care as well as utilization costs.
The pace of change in healthcare will only accelerate in 2015. Innovative, creative and forward-looking hospital and health system pharmacies will seize the moment and convert that change into opportunities to improve patient care and business health in the year ahead.